Taking herbal supplements with prescription medication can affect your blood pressure, according to researchers at Assaf Harofeh Medical Center in Tzrifin and the Emek Medical Center in Afula. Writing in the Israeli Journal of Hypertension, Dr. Amos Ziv and colleagues note that abut 100 herbs are reported to have an effect on blood pressure. Most of them - especially those that increase urination - have been found to lower blood pressure, while a few have been found to raise it. Depending on the dose, ginseng can either raise or lower it. The problem is that most doctors and patients have no clue about these effects, and can lower or raise blood pressure too much. A number of plants used by traditional Chinese healers have been shown to treat hypertension, and these have been studied extensively. But many others haven't. Some substances are even in your kitchen: Garlic is thought to reduce blood pressure by causing smooth muscle relaxation and vasodilation. Dan Gui, from the dried root of the Angelica sinesis plant, and used extensively in Chinese medicine for a variety of gynecological problems, has been shown to decrease blood pressure, while Ma Huang (also known as Herba ephedra), which is used for weight loss and poses a number of serious risks, has been shown to increase blood pressure and heart rate. The researchers warn that improper use of herbal agents in conjunction with conventional medication may counteract or intensify a drug's effect and produce harmful reactions. They call on doctors and other health care practitioners to ask patients about the use of herbal supplements. Healthcare professionals should also become familiar with commonly used herbal agents, the researchers concluded. RED CROSS CAMPAIGN TO PROTECT MEDICAL WORKERS The International Committee of the Red Cross is launching an awareness campaign in the territories to highlight the need to safeguard medical personnel and health facilities. The effort will be run in cooperation with the Palestinian Red Crescent Society and the Palestinian Authority's health ministry. "The campaign reflects a shared concern about the increasing lack of respect for medical services," says Katharina Ritz, the ICRC's head of mission for the territories. "Protecting medical staff and structures from attack, and facilitating the evacuation and treatment of the sick and wounded - no matter who they are - are fundamental requirements under international humanitarian law." This campaign forms part of a series of initiatives in both Israel and the territories that includes training sessions, seminars, competitions, activities for students, and dialogue - all aimed at raising awareness of obligations toward medical services. "Responsibility for protecting medical services falls on many shoulders - including those of medical staff themselves," says Ritz, "but it is particularly the responsibility of the Israeli and Palestinian authorities, of members of their armed forces, to ensure that people trying to save lives are not targeted while doing so." LIMIT CAFFEINE INTAKE DURING PREGNANCY High daily doses of caffeine during pregnancy - whether from coffee, tea, soft drinks or chocolate - raise the risk of miscarriage, according a new study by the Kaiser Permanente research division. This study ruled out other causes of nausea and vomiting such as morning sickness that have tended to interfere with the determination of caffeine's true effect on miscarriage risk and cause many pregnant women to avoid caffeine. The research appeared recently in the American Journal of Obstetrics and Gynecology. Dr. De-Kun Li, a researcher for America's largest health maintenance organization, said the study strengthens the association between caffeine and miscarriage risk because it removes speculation that the association was due to reduced caffeine intake by healthy pregnant women. The researchers looked at the records of 1,063 pregnant members of the HMO who hadn't changed their pattern of caffeine consumption during pregnancy. Women who consumed 200 mg or more of caffeine per day (two or more cups of coffee or five cans of caffeinated beverages) had twice the miscarriage risk as women who consumed no caffeine, said Li. The increased risk of miscarriage appeared to be due to the caffeine itself, because caffeine intake from non-coffee sources such as soft drinks, tea and hot chocolate showed a similar increased risk of miscarriage. "The main message for pregnant women is that they probably should consider stopping caffeine consumption during pregnancy," Li said. Caffeine crosses the placenta, but can be difficult for the fetus to metabolize because of its under-developed metabolic system. Caffeine also may influence cell development and decrease placental blood flow, which may lead to an adverse effect on fetal development. "If you need caffeine to get you going, try keeping it to one cup or less a day. Avoiding it may be even better. Consider switching to decaffeinated coffee and other decaffeinated beverages during your pregnancy," advised Dr.Tracy Flanagan, director of women's health at the HMO Kaiser Permanente Northern California. "Learn to perk up instead with natural energy boosters like a brisk walk, yoga stretches, or snacking on dried fruits and nuts."

Health Scan: Drug abuse

Herbal supplements with medication can alter blood pressure, researchers say.